Fazal I Wahid, Qaisar Khan, Adil Khan, Iftikhar Ahmad Khan.
Pattern of causes and management of permanent loss of voice studied at a tertiary care hospital.
J Postgrad Med Inst Jan ;27(2):188-93.

Objective: To determine the frequency of causes of hoarseness leading to permanent loss of voice and discuss their management. Methodology: This descriptive study was carried out at the department of ENT, Head and Neck Surgery, Lady Reading Hospital Peshawar from January 2009 to December 2011. All these patients were evaluated in terms of detailed history, thorough examination and relevant investigations. Biopsy from laryngeal mass was taken in case of tumours. Total laryngectomy was performed in patients with advanced laryngeal tumours provided with preoperative counseling regarding postoperative handicaps. The patients with laryngeal narrowing due to trauma were subjected to laryngeal stenting. The data was analyzed using SPSS 15. Results: Out of 16 patients 10 were male and 6 were female with male: female ratio of 1.6:1. The ages ranged from 09-75 years with mean age of 43.68 + S.D 18.65 years. Majority of patients (68.75%) had low socioeconomic status. Main presentation of these patients was hoarseness (100%). The commonest cause of change of voice was laryngeal carcinoma (n-6, 37.5%), followed by blast injury (25%). Endolaryngeal stenting was the commonest (43.75%) procedure performed for traumatic laryngeal stenosis followed by total laryngectomy. Most of the patients gained good esophageal speech. Conclusion: It is concluded that beside laryngeal cancer, trauma to the larynx is a common cause of permanent loss of voice resulting due to increased incidence of violence in our set up. Esophageal speech can be easily and successfully instituted in laryngectomized patients among other voice rehabilitative options.

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